AMERICAN SOCIETY FOR QUALITY QUALITY 101 Michael Hagan, D.O., MHSA, CMQ
Tangible Increase in earnings Decrease in waste Increase in productivity Intangible Customer goodwill Alignment between business activities Module 1: Quality Benefits
Meeting customer needs + wants = quality. Quality improves products/services and processes. Improved products/services and processes = profitability. W. Edwards Deming on Quality
A Quality Approach Benefits . . . Organizations Employees Customers Suppliers Society
Benefits to Employees Product quality Pride in products and services Job satisfaction Process quality Improved communications Streamlined work processes Customer satisfaction Happier customers Strong customer relationships Profit Greater job security/benefits
Quality Studies and Standards Strategic Planning Institute Released the Profit Impact of Market Strategy (PIMS) study. National Institute of Standards and Technology Partnered with the Baldrige recognition program. Both organizations support the link between quality and profitability.
N I S T • National Institute Standards & Tech • Baldrige Quality Award • Baldrige index • Outperforms the S & P 500 index
IT WORKS • Companies that look at themselves and constantly ask the question • “how can we improve” • Are more successful as a company
External and Internal Customers Publication Department Sales Department Customer
BENEFITS TO CUSTOMERS • External Customer Person or organization that (buys) receives the product or service • Transplant center • Other OPO • Donor hospital • Tissue Bank
BENEFITS TO CUSTOMERS • Internal Customer Employee or department that receives the output • OPO Coordinators • OPO HD • OPO Finance department
Benefits to Customers Quality results in: • Increased choices. • Improved goods and services. • Expectations met or exceeded.
Benefits to Suppliers • Achievement of performance requirements • Streamlined processes • Efficient communication • Increased customer satisfaction
Benefits to Society Economic growth and stability Increased employment opportunities Product safety
OPO’s BENEFIT TO SOCIETY • Disease free organs and tissues • Better functioning organs • More transplants • More lives saved
Module 2: The Evolution of Quality • Provides a framework for understanding the history of the quality movement. • Expands the definition of quality.
QUALITY DEFINED • Many definitions • No perfect definition • Usually it is very clear when quality is missing
MISSING QUALITY • Missing a pt on the match run • Incorrect lab, HLA, etc. • Mislabeled blood type • Surgical damage • Liver in a heart box
JURAN FITNESS FOR USE • Degree to which the product or service conforms to design • The degree to which the transplant centers are called on each of their patients
JURAN FITNESS FOR USE • Product or service availability, reliability, and maintainability • Reliability of the software systems to produce accurate match runs
JURAN FITNESS FOR USE • Available customer service • Ability of transplant centers to request customer service from the OPO
ISO Definition of Quality • Degree to which a set of characteristics fulfills requirements Product: Telephone Characteristic: Speed dial Requirements: Convenience and speed
Crosby’s Definition of Quality • Quality is conformance to requirements. • Requirements are answers to key organizational questions: • How quickly will orders ship? • What is our return policy? • What forms of payment are acceptable?
Quality Evolution: Medieval Guilds • Guilds: • Developed strict rules for products and services. • Used stamps to identify flawless goods.
Quality Evolution: Product Orientation • Master craftsmen trained apprentices. • Industrial Revolution divided trades into specialized tasks; inspectors guaranteed quality. • Taylor system increased productivity; inspection departments found defects.
Quality Evolution: Process Orientation • Processes became critical. • Shewhart identified statistical quality control. • Developed strict rules for products and services. • Quality became relevant for process, not just product.
PROCESS ORIENTATION • Shewart: in 1920s, Bell Labs • Process yields data • Data can be analyzed • Statistical analysis and control • Control charts for the process
Quality Evolution: Wartime • Quality became a safety issue. • The military developed a sampling inspection system and trained suppliers.
Quality Evolution:Total Quality Movement • Developed in response to Japanese quality movement. • Focused on improving all processes through people who used them.
Use of Standards • Definition: A standard is a “statement, specification, or quantity of material against which outputs may be judged as acceptable or nonacceptable.” • Result: Interchangeable products. • Examples: Military and ISO 9000 standards.
ISO Registration Step 1 Independent third party audits the quality management system. Step 2 Certificate of registration awarded when audit is passed. Step 3 Registration is maintained via surveillance audits.
Baldrige Program • Improves organizational performance. • Facilitates the sharing of best practices. • Provides a tool for managing performance and guiding planning and opportunities for learning.
BALDRIGE 7 CATEGORIES • Leadership • Strategic planning • Customer & market focus • Information and analysis • Human resource • Process management • Business results
BALDRIGE CORE VALUES • Visionary leadership • Customer driven excellence • Organizational & personal learning • Valuing employees and partners • Agility • Focus on the future
BALDRIGE CORE VALUES • Managing for innovation • Management by fact, data • Public responsibility & citizenship • Focus on results, creating value • Systems perspective
QUALITY QUESTIONS • What does AOPO consider a good quality OPO? • One that has met accreditation requirements
QUALITY QUESTIONS • What does CMS consider as a good quality OPO? • One that has met the CMS contractual requirements
QUALITY QUESTIONS • What does UNOS consider as a POOR quality OPO or program? • St. Vincent, skipped candidates, program now closed
NOT QUALITY • There is a very real cost of poor quality or lack of quality. • Cost of time, resources, people • Poor outcomes, fewer transplants
QUALITY IMPROVEMENT • HRSA Collaboratives and AOPO Quality Council • Strive to improve quality • More transplants, save more lives
QUALITY GOAL • All 58 OPOs • High quality OPOs • High quality organs and allocation